Ventilator-Associated Pneumonia

It has been repeatedly stated that oral care is important in the prevention of ventilator-associated pneumonia (VAP). Endotracheal intubation predisposes patients to developing VAP. The tube acts as a conduit from the mouth to the lungs – a perfect track for bacteria to descend upon. Khezeri, et al. (2014) suggest that “the presence of an endotracheal tube (ETT) inhibits normal coughing, normal swallowing, and the protection of the trachea contact by epiglottis closure.” In addition, an endotracheal tube keeps the patients mouth open – leading to dryness. Bacteria are not washed away by saliva. Also, Landgraf, et al. (2017) mention that the presence of an endotracheal tube in the mouth causes “changes in the oral epithelium” which “might indicate risk for infection in intensive care patients

As a nurse in a skilled nursing facility, oral hygiene care is very important, but the importance significantly increases when our patients are functionally dependent or cognitively impaired. These patients are unable to perform this task and depend on nurses to provide daily care. Nurses need to pay close attention for potential problems. They will need to perform assessments, develop oral care plans, and identify preventions and strategies to eliminate any potential problems. Poor oral health has been linked to serious systemic illnesses including diabetes mellitus, stroke, hypertension, myocardial infarction and aspiration pneumonia (Dyck et al., 2012). Patients who suffer from a lack of oral care can have a dramatic impact to their

VAP is defined as a patient who is mechanically ventilated for greater than 48 hours and exhibits three out the five symptoms: fever, increase leukocytosis, change in sputum color or amount, radiographic evidence of new/progressive infiltrates and worsening oxygen requirements along with a culture identifying a bacterial microorganism (CDC, 2008). Risk factors associated with the formation of VAP is the altered oral physiology where there is a decrease in saliva production decreasing the pH level forming an ideal environment for bacteria to grow, respiratory pathogens such as Staphylococcus aureus, Streptococcus pneumonia, Methicillin Resistant Staphylococcus aureus and Pseudomonoas aeruginosa which can form a biofilm on the teeth that we know as plaque that can then aspirate and travel down to the lungs (Koeman et al., 2006). Several studies (Munro et al., 2009) have verified that removing bacteria from the oropharynx requires the removal of dental plaque, and the only way to remove the plaque is with toothbrushing. Others found that the majority of nurses use a soft Toothette instead of toothbrushing and that the Toothettes do not

The purpose of this document is a critical study and analysis of the oral care provided by nursing staff as part of the Ventilator Care Bundle (VCB) and to assess whether the frequency of mouth care performed is related to the prevention of Ventilator Associated Pneumonia (VAP) in patients mechanically ventilated (Zilberberg et al. 2009).

To encourage physicians, ICU nurses, and respiratory therapist to use the ventilator associated pneumonia bundle in all ventilated patients in an intensive care unit.

This paper explores Pneumonia and the respiratory disease process associated with bacterial and viral pathogens most commonly located in the lung. The paper examines the process, symptoms and treatments most commonly viewed in patient cases of Pneumonia. My goal is to educate the reader and to warn of the

Ventilator - associated pneumonia (VAP) is the second most common hospital acquired infection (HAI) and is associated with high morbidity and mortality rates for ventilated patients in intensive care units (Bingham, Ashley, Jong, & Swift, 2010). The VAP increases patients’ mortality rates, length of stay and hospital costs (Hiner, Kasuya, Cottingham, & Whitney, 2010). The VAP is the leading causes of death due to nosocomial infections and the

Even though the consequence of saline instillation on a ventilator patient in the acute care setting is pneumonia or the patient may become hemodynamically unstable, this practice remain contentious, the practice of this procedure will also decrease the oxygenation. (Ayhan, et al., 2015),

38. American Journal of Respiratory care and critical care Medicine, Volume 175, issue 7, pages 698 – 704

Ventilator-associated pneumonia is a bacterial infection that occurs in the lower respiratory system within the first 48 hours of endotrachal intubation (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). Although any hospital patient is susceptible to pneumonia, ventilator dependent patients are at the highest risk of acquiring pneumonia. The purpose of this paper is to identify the risk factors, incidences, and preventions of ventilator-associated pneumonia (VAP) using a quantitative research study performed in Malaysia. “The aim of this

The authors of Current Opinion in Pulmonary Medicine state that “Ventilator-associated pneumonia (VAP), a subset of HAP that occurs in mechanically ventilated patients more than 48 h after tracheal intubation” The type of ventilator that is needed to treat patients is called a mechanical ventilator. For these ventilators, a tube has to be inserted down the person’s throat thus causing more bacterial to get inside the patient’s body. Conclusion While most may think that hospitals are an environment for patients to return to their healthy state, hospitals can also be an environment where it deters them from healing. Hospital-acquired illnesses kill many each year and is due to reason of neglect or misuse of equipment.

From investigation in health practices, ventilator associated pneumonia caught my attention. “Ventilator Associated Pneumonia (VAP) is a leading cause of morbidity and mortality in intensive care units. Most episodes of VAP are thought to develop from the aspiration of oropharyngeal secretions containing potentially pathogenic organisms. Aspiration of gastric secretions may also contribute, though likely a lesser degree. Tracheal intubation interrupts the body’s anatomic and physiologic defenses against aspiration, making mechanical ventilation a major risk for Ventilator Associated Pneumonia. Semi-recumbent positioning of mechanically ventilated patients may help reduce the incidence of gastroesophageal reflux and lead to a decreased incidence of VAP. The one randomized trial to date of semi- recumbent positioning shows it to be an effective method of reducing VAP. Immobility in critically ill patients leads to atelectasis and decreased clearance of bronchopulmonary secretions. The accumulation of contaminated oropharyngeal secretions above the endotracheal tube cuff may contribute to the risk of aspiration. Removing these

Pneumonia is an inflammation of the lung which results into an excess of fluid or pus accumulating into the alveoli of the lung. Pneumonia impairs gas exchange which leads to hypoxemia and is acquire by inhaling a contagious organism or an irritating agent. (Ignatavicius & Workman, 2013). Fungal, bacteria and viruses are the most common organisms that can be inhale. Pneumonia could be community-acquired or health care associated. Community –acquired pneumonia (CAP) occurs out of a healthcare facility while health care associated pneumonia (HAP) is acquired in a healthcare facility. HAP are more resistant to antibiotic and patients on ventilators and those receiving kidney dialysis have a higher risk factor. Infants, children and the elderly also have a higher risk of acquiring pneumonia due to their immune system inability to fight the virus. Pneumonia can also be classified as aspiration pneumonia if it arises by inhaling saliva, vomit, food or drink into the lungs. Patients with abnormal gag reflex, dysphagia, brain injury, and are abusing drug or alcohol have a higher risk of aspiration pneumonia (Mayo Clinic, 2013). In the case of patient E.O., this patient had rhonchi in the lower lobe and the upper lobe sound was coarse and diminished. Signs and symptoms of pneumonia include difficulty breathing, chest pain, wheezing, fever, headache, chills, cough, confusion, pain in muscle or

“Teaching patients about promoting, maintaining, and restoring their health is a required nursing skill that most often results in a positive outcome, enhancing the patient 's quality of life” (Lewis et al., 2014, p.52). The intent of this analysis is to educate patients with chronic obstructive pulmonary disease on means that can enhance their quality of life and avert the progression of their disease. More specifically, it will focus on the aspect of teaching Mrs. N, a patient, how to effectively handle certain symptoms experienced with techniques like pursed-lip breathing and also, to upsurge the client’s awareness on preventative measures to abate the possibility of acute exacerbations. Mrs. N is a 100-years-old woman of Canadian and Arabic background. In mid-September, she was rushed to the hospital after experiencing worsening dyspnea and a fever. The doctors deduced a diagnosis of pneumonia and therefore, she was transferred to the medical unit at the Lakeshore hospital in order to be treated with intravenous antibiotics. Mrs. N has a past medical history of chronic obstructive pulmonary disease, hypertension, anemia, deep vein thrombosis and mixed dementia. Mrs. N is a retired widow with two daughters, who come and visit her on a daily basis at the hospital and encourage her to mobilize and eat because she has an extremely poor appetite on most days. She’s well cared for by a team of care workers in the nursing home where she lives and her daughters and

The clinical manifestations of pneumonia will be different according to the causative organism and the patient’s underlying conditions and/or comorbidities (Smeltzer, et al). Some of the manifestations are